Akademisches Auslandsamt Daniela Ehrenreich Neidenburger Str. 43, 45897 Gelsenkirchen Tel : 0209 9596-826 Fax : 0209 9596-447 E-Mail: daniela.ehrenreich@w-hs.de

Mr. / Mrs.

home university

from (day, month, year)

to (day month, year)

is enrolled as an ERASMUS student at our institution

Name of signatory

Function

ERASMUS academic year 2015 / 2016

Confirmation of Stay

It is hereby certified that

Date

Name of host organisation

To be completed by the host institution:

Stamp and Signature